高科技醫療儀器利用之探討：以某大學附設醫院加馬刀中心為例

The Study on Utilization of High Technology Medical Devices: Example from Gamma Knife Department of a Medical Center

王俊文(Jiunn-Wei Wang) ； 王凱淞(Kai-Sung Wang) ； 張時獻(Shih-Hsien Chang) ； 葉德豐(Te-Feng Yeh)

《醫務管理期刊》 4卷4期 (2003/12) Pp. 1-13

https://doi.org/10.6174/JHM2003.4(4).1

摘要

醫療科技的使用被認為是造成醫療費用高漲的主要原因之一，健保的廣泛給付使得醫療院所與民眾有更強烈的經濟動機去引入與使用高科技醫療儀器。衛生主管機關應設法控制醫療費用的上漲及支出；醫療院所則須解決同儕裝備競賽與成本管控兩者問的難題；民眾在接受高（新）科技之未知性與不確定性時需考慮的因素也相形複雜。
本研究以加馬刀為例，分別探討醫療院所（醫療供給者）購置高科技醫療儀器時的評估方式以及民眾（被保險人）接受高（新）科技醫療時之考量因素。
從研究結果得知，我國醫療科技評估(HTA)正處於起步階段，大致已有初步的評估組織與運作模式，唯體制與執行上需更加完善與落實；醫療院所大多著重在該科技對其經營與發展是否有直接與立即性影響；病患多數會因醫師的建議而接受診療，但副作用的影響仍為病患顧慮的重要因素。在未來醫療高科技化的趨勢下，期望衛生主管機關及保險人能更臻完備與落實科技評估制度，為處於資訊不對等下的民眾把關，保障台灣整體醫療環境與國人就醫品質。

關鍵字

高科技醫療儀器 ； 醫療科技評估 ； 加馬刀

並列摘要

The utilization of health technology is always considered as one of the main reasons for inflation of medical expenditure, the broader range of reimbursement content leads to high incentive to introduce and utilize those high- technology medical devices. The health authority always try to control national medical expenditure and its inflation, meanwhile the healthcare organizations face the dilemma between facilities/devices expansion and cost containment. Therefore the consumers' concerns of accepting uncertain but new technology for their health services are apparently complicated.
According to the result of the study, Taiwan's health technology assessment (HTA) has already built up some prototype but still on the early stage without much practical execution. Most healthcare organizations always focus on the direct impact on their revenue when considering the adoption of new medical devices. Most consumers usually concern side effect and receive high-technology medical services mainly due to their physicians' advices. Under the trend of application of high technology, government and insurer should be more fulfilling the evaluation process and may preserve the right and quality of healthcare services for the insured and civilian.

並列關鍵字

high-technology medical device ； health technology assessment ； Gamma Knife

參考文獻

Anderson, G. F.,Steinberg, E. P.,A. C. Gelijns,H. V. Dawkins. （Eds.）(1994).Medical innovation at the crossroads: Vol IV Adopting new medical technology.Washington, DC:National Academy Press.

Anderson, H. J.(1990).Survey identifies trends in equipment acquisitions.Hospitals.64,30-35.

Weingart, S. N.(1995).Deciding to buy expensive technology.International Journal of Technology Assessment in Health Care.11(2),301-315.

加馬刀簡介

王乃弘、黃松共(1994)。民眾對選擇醫院因素及態度之研究－以中部數家醫院為例。醫院雜誌。29(2)，1-15。